Background The microbiota is a potential source of biomarkers for clinical outcomes in chronic respiratory conditions, but its role in Mycobacterium abscessus pulmonary disease (PD) remains unexplored. We aimed to identify microbial signatures in fecal and sputum microbiotas associated with treatment response in patients with M. abscessus PD. Methods We conducted a cohort study prospectively enrolling patients undergoing antibiotic treatment for M. abscessus PD. Fecal and sputum samples were collected before, and 2 weeks and 6 months after, treatment initiation. 16S rRNA amplicon sequencing approach was used to characterize the microbiotas. After categorizing patients as early treatment responders and non-responders based on sputum culture results at 2 weeks, we elucidated the differences in their diversity and composition of microbiotas. Results Among 32 patients enrolled, 27 patients (median 66 years, 85.2% women, 48.1% with subspecies abscessus) were included for microbiota analysis. Fifteen patients (55.6%) achieved negative conversion at 2 weeks, which was maintained in 14 (93.3%) after 6 months. Alpha-diversity of the fecal microbiota after 2 weeks of treatment decreased significantly in responders, but not in non-responders (P=0.029). Increased abundance of Eubacterium hallii group in baseline fecal microbiota was indicative of unresponsiveness to antibiotics, whereas an increase in Enterococcus in fecal microbiota at week 2 was linked with favorable response. Increased abundance of Burkholderia-Caballeronia-Paraburkholderia and Porphyromonas in baseline, and decreased abundance of Rothia in week 2 sputum microbiota were also associated with good treatment response. Conclusions In M. abscessus PD, changes in microbial diversity and compositional signatures vary with treatment response.

中文翻译：

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脓肿分枝杆菌肺病患者的粪便和痰液微生物群及治疗反应


背景 微生物群是慢性呼吸系统疾病临床结果生物标志物的潜在来源，但其在脓肿分枝杆菌肺病 （PD） 中的作用仍未得到探索。我们旨在确定与脓肿分枝杆菌 PD 患者治疗反应相关的粪便和痰液微生物群中的微生物特征。方法我们进行了一项队列研究，前瞻性地招募了接受脓肿分枝杆菌 PD 抗生素治疗的患者。在治疗开始前、治疗开始后 2 周和 6 个月收集粪便和痰液样本。采用 16S rRNA 扩增子测序方法表征微生物群。根据 2 周时的痰培养结果将患者分为早期治疗反应者和无反应者后，我们阐明了他们微生物群的多样性和组成的差异。结果 在 32 例入组患者中，纳入 27 例患者 （中位 66 岁，85.2% 女性，48.1% 亚种脓肿） 进行微生物群分析。15 例患者 （55.6%） 在 2 周时达到阴性转换，14 例 （93.3%） 在 6 个月后维持。治疗 2 周后，反应者粪便微生物群的 α 多样性显着降低，但无反应者没有 （P = 0.029）。基线粪便微生物群中 Eubacterium hallii 组的丰度增加表明对抗生素无反应，而第 2 周粪便微生物群中肠球菌的增加与良好的反应有关。基线中 Burkholderia-Caballeronia-Paraburkholderia 和 Porphyromonas 的丰度增加，以及第 2 周痰液微生物群中 Rothia 丰度的降低也与良好的治疗反应有关。结论 在 M. 脓肿 PD、微生物多样性和成分特征的变化随治疗反应而变化。